Towards that effect here are some quotes about the size of the problem in one community which may not apply exactly to all communities but the figures and the statistics may not matter. In this study, it has been found that about 66% of all women have sexual concerns, including lack of desire (33%), lack of pleasure in sexual contact (20%), pain with vaginal penetration (15%), problem with arousal (18%-48%), problems attaining climax (46%) and complete lack of orgasm (15%-24%). The major categories of the sexual dysfunction includes various types and reasons, and to determine which factor or reason is the major cause for the problem, one needs some work.

• These types and categorization includes :
  Inhibited or hypoactive sexual desire : a disinterest in sexual contact or complete lack of sexual desire.
• Sexual arousal disorder : the inability to become aroused, including lack of erotic feelings and physical signs of arousal, such as nipple erection, vaginal lubrication, and changes in blood flow to the labia, clitoris, and vagina.
• Orgasmic disorder : the inability to have an orgasm (sexual climax) despite the ability to become sexually aroused and despite adequate sexual stimulation.
• Dyspareunia : pain with intercourse or attempted intercourse.
• Vaginismus: a disorder in which the muscles around the entrance to the vagina spasm uncontrollably, making vaginal penetration and/or intercourse painful and extremely difficult or impossible.

Causes of Sexual Problems

• Because the sexual response is so complex, there are many causes of sexual dysfunction.
• Misinformation or poor techniques contribute to sexual problems. Only about one in three women reaches a climax regularly through intercourse alone, without additional stimulation of the clitoris. About 10% of women never achieve orgasm. But it is possible and even common, to have a pleasurable sex life without orgasm.
• Environmental factors may interfere with sexual functioning. It may be difficult to perform sexually if there is no safe, private place to relax and to become sexual or if fatigue due to an overly busy work and personal life robs the energy to participate sexually. Parents may find it difficult to find the time to be sexually intimate, given the demands and presence of their children.

Sexual functioning may be affected by medical conditions such as:

1. High blood pressure, diabetes, kidney disease, multiple sclerosis or spinal cord injury, thyroid disease and other hormone disorders.
2. The consequences of radiation therapy for cancer
3. Any other condition that causes fatigue and debilitation
4. Premature menopause or removal of ovaries

Pain during intercourse (dyspareunia) may occur as a result of :

Painful ovarian cysts, pain or spasm of the vaginal muscles, pelvic infections, endometriosis, uterine or bladder prolapse, inadequate vaginal lubrication which can happen with menopause, skin conditions of the vulva and vagina called lichen sclerosis, an abnormally formed vagina (due either to a birth defect, poor repair after childbirth or radiation damage), a poor-fitting contraceptives, an allergic reaction to certain condoms or spermicidal jellies or foams. Fears or anxiety or any combination of one or more of the above conditions.

A variety of medications and drugs can also interfere with sexual functioning, including is alcohol consumption, drugs to treat high blood pressure, pain medications, sedatives, certain antidepressants, antipsychotic medications

Psychological factors may play a role, particularly if the problem is lack of desire or inability to get aroused. It may be difficult to enjoy a sexual relationship if the person is

• Under a lot of stress.
• The relationship is troubled.
• There is a history of traumatic sexual encounters.
• One was raised in a family with strict sexual taboos or has poor body image.

Being afraid of getting pregnant or of contracting a sexually-transmitted disease or have negative feelings (including guilt, anger, fear, and low self-esteem) or have an anxiety disorder or being depressed. The most important way for diagnosing a sexual problem is to listen carefully to the story, review all factors, performs a thorough physical and pelvic examination.

Tests for hormonal dysfunction and all sexually transmitted disease is part of the integral management.The tests for hormonal dysfunction includes the sex hormones, estrogen, testosterone, etc., thyroid and checks for diabetes and kidney disease.
All of these need patience from both health care provider and the health care seeker. Once the situation aired thoroughly, treatment can be tailored accordingly. The physical and hormonal side can be sorted out. The psychological and behavior matters will be dealt with. Instructions and training for relaxation, elimination of guilt and fear.

Relaxed, clear teaching to promote understanding of one’s own body and of sexual functioning, emphasizing the importance and normality of sexuality, is critical in avoiding the guilt and fear that sometimes result in sexual dysfunction.

It is pertinent here to advice that reading and acquiring information through the internet is most helpful and indeed with the aid of the health care providers, most sexual health problems can be dealt with and sorted out successfully.

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